Eleanor Smith

The review of national standards for healthcare food for patients, staff and visitors is bringing together relevant food requirements and best practice from the National Health Service. The new standards will reflect Government nutrition advice, as outlined in Public Health England’s (PHE) Eatwell Guide.

The review of national standards for healthcare food is being developed alongside the Hospital Food Review and the new standards are expected to be published early next year.

The Hospital Food Review is being undertaken by a Panel chaired by Philip Shelley, Facilities Manager at Taunton and Somerset NHS Foundation Trust. The members of the Panel are:

- Emma Brookes, NHS Improvement;

- Michael Bellas, NHS Improvement;

- Tina Potter, Food Standards Agency;

- Rachel Manners, PHE;

- Martin Steele, NHS Property Services;

- Kerry Trunks, NHS/Ward Sister;

- Craig Smith, Hospital Caterers Association (HCA);

- Gail Walker, HCA/Open Door;

- Balwinder Dhoot, Department for Environment, Food and Rural Affairs;

- Susannah McWilliam, Soil Association;

- Maxine Cartz, British Dietetic Association (BDA);

- Andy Burnham, BDA;

- Jason Yiannikkou, Department of Health and Social Care (DHSC); and

- William Vineall, DHSC.

Prue Leith has been appointed as an advisor to the review.

The review will also consult other key stakeholders, including NHS trusts, professional associations, patient representatives and commercial suppliers. Organisations involved in the provision of food to the NHS that will be consulted include:

- Apetito;

- Anglia Crown;

- Tillery Valley;

- Brakes;

- Bidfood; and

- Healthy Food Company.

This is not an exhaustive list and other organisations may be consulted.

The Hospital Food Review is scheduled for completion in January 2020.

The review of national standards for healthcare food for patients, staff and visitors is bringing together relevant food requirements and best practice from the National Health Service. The new standards will reflect Government nutrition advice, as outlined in Public Health England’s (PHE) Eatwell Guide.

The review of national standards for healthcare food is being developed alongside the Hospital Food Review and the new standards are expected to be published early next year.

The Hospital Food Review is being undertaken by a Panel chaired by Philip Shelley, Facilities Manager at Taunton and Somerset NHS Foundation Trust. The members of the Panel are:

- Emma Brookes, NHS Improvement;

- Michael Bellas, NHS Improvement;

- Tina Potter, Food Standards Agency;

- Rachel Manners, PHE;

- Martin Steele, NHS Property Services;

- Kerry Trunks, NHS/Ward Sister;

- Craig Smith, Hospital Caterers Association (HCA);

- Gail Walker, HCA/Open Door;

- Balwinder Dhoot, Department for Environment, Food and Rural Affairs;

- Susannah McWilliam, Soil Association;

- Maxine Cartz, British Dietetic Association (BDA);

- Andy Burnham, BDA;

- Jason Yiannikkou, Department of Health and Social Care (DHSC); and

- William Vineall, DHSC.

Prue Leith has been appointed as an advisor to the review.

The review will also consult other key stakeholders, including NHS trusts, professional associations, patient representatives and commercial suppliers. Organisations involved in the provision of food to the NHS that will be consulted include:

- Apetito;

- Anglia Crown;

- Tillery Valley;

- Brakes;

- Bidfood; and

- Healthy Food Company.

This is not an exhaustive list and other organisations may be consulted.

The Hospital Food Review is scheduled for completion in January 2020.

The review of national standards for healthcare food for patients, staff and visitors is bringing together relevant food requirements and best practice from the National Health Service. The new standards will reflect Government nutrition advice, as outlined in Public Health England’s (PHE) Eatwell Guide.

The review of national standards for healthcare food is being developed alongside the Hospital Food Review and the new standards are expected to be published early next year.

The Hospital Food Review is being undertaken by a Panel chaired by Philip Shelley, Facilities Manager at Taunton and Somerset NHS Foundation Trust. The members of the Panel are:

- Emma Brookes, NHS Improvement;

- Michael Bellas, NHS Improvement;

- Tina Potter, Food Standards Agency;

- Rachel Manners, PHE;

- Martin Steele, NHS Property Services;

- Kerry Trunks, NHS/Ward Sister;

- Craig Smith, Hospital Caterers Association (HCA);

- Gail Walker, HCA/Open Door;

- Balwinder Dhoot, Department for Environment, Food and Rural Affairs;

- Susannah McWilliam, Soil Association;

- Maxine Cartz, British Dietetic Association (BDA);

- Andy Burnham, BDA;

- Jason Yiannikkou, Department of Health and Social Care (DHSC); and

- William Vineall, DHSC.

Prue Leith has been appointed as an advisor to the review.

The review will also consult other key stakeholders, including NHS trusts, professional associations, patient representatives and commercial suppliers. Organisations involved in the provision of food to the NHS that will be consulted include:

- Apetito;

- Anglia Crown;

- Tillery Valley;

- Brakes;

- Bidfood; and

- Healthy Food Company.

This is not an exhaustive list and other organisations may be consulted.

The Hospital Food Review is scheduled for completion in January 2020.

The review of national standards for healthcare food for patients, staff and visitors is bringing together relevant food requirements and best practice from the National Health Service. The new standards will reflect Government nutrition advice, as outlined in Public Health England’s (PHE) Eatwell Guide.

The review of national standards for healthcare food is being developed alongside the Hospital Food Review and the new standards are expected to be published early next year.

The Hospital Food Review is being undertaken by a Panel chaired by Philip Shelley, Facilities Manager at Taunton and Somerset NHS Foundation Trust. The members of the Panel are:

- Emma Brookes, NHS Improvement;

- Michael Bellas, NHS Improvement;

- Tina Potter, Food Standards Agency;

- Rachel Manners, PHE;

- Martin Steele, NHS Property Services;

- Kerry Trunks, NHS/Ward Sister;

- Craig Smith, Hospital Caterers Association (HCA);

- Gail Walker, HCA/Open Door;

- Balwinder Dhoot, Department for Environment, Food and Rural Affairs;

- Susannah McWilliam, Soil Association;

- Maxine Cartz, British Dietetic Association (BDA);

- Andy Burnham, BDA;

- Jason Yiannikkou, Department of Health and Social Care (DHSC); and

- William Vineall, DHSC.

Prue Leith has been appointed as an advisor to the review.

The review will also consult other key stakeholders, including NHS trusts, professional associations, patient representatives and commercial suppliers. Organisations involved in the provision of food to the NHS that will be consulted include:

- Apetito;

- Anglia Crown;

- Tillery Valley;

- Brakes;

- Bidfood; and

- Healthy Food Company.

This is not an exhaustive list and other organisations may be consulted.

The Hospital Food Review is scheduled for completion in January 2020.

It is the responsibility of National Health Service trusts to have staffing arrangements in place that deliver safe and effective care. This includes recruiting the appropriate professionals needed to support these levels and meet local needs.

Dermatology is a highly competitive specialty training pathway and often oversubscribed. Nationally and locally there has been a 100% fill rate in dermatology training for the past four years. Since 2010, the number of full-time equivalent dermatologists (doctors at the consultant grade) has increased by 26% rising from 464 in May 2010 to 584 in May 2019.

The interim NHS People Plan, published on 3 June 2019, puts the workforce at the heart of the NHS and will ensure we have the staff needed to deliver high quality care. In advance of publishing the final People Plan, the NHS will establish a national programme board to address geographical and specialty shortages in medicine.

It is the responsibility of National Health Service trusts to have staffing arrangements in place that deliver safe and effective care. This includes recruiting the appropriate professionals needed to support these levels and meet local needs.

Dermatology is a highly competitive specialty training pathway and often oversubscribed. Nationally and locally there has been a 100% fill rate in dermatology training for the past four years. Since 2010, the number of full-time equivalent dermatologists (doctors at the consultant grade) has increased by 26% rising from 464 in May 2010 to 584 in May 2019.

The interim NHS People Plan, published on 3 June 2019, puts the workforce at the heart of the NHS and will ensure we have the staff needed to deliver high quality care. In advance of publishing the final People Plan, the NHS will establish a national programme board to address geographical and specialty shortages in medicine.

It has not proved possible to respond to the hon. Member in the time available before Prorogation.

As set out in the NHS Long Term Plan, the National Health Service is committed to supporting the timely introduction of the most clinically and cost effective treatments for patients. Cell and gene therapies have the potential to provide great benefits for patients, and the NHS is leading the world in creating access to these treatments.

For example, patients in England were among the first in the world to benefit from CAR T cell therapy, which uses their own immune system to fight cancers. The NHS will also now be funding voretigene neparvovec, also known as Luxturna, a revolutionary form of new treatment for blindness in children.

The NHS is working with the National Institute for Health and Care Excellence and other partners in the Accelerated Access Collaborative to take a proactive approach in preparing for cell and gene therapies and other innovative treatments.

It has not proved possible to respond to the hon. Member in the time available before Prorogation.

The Elective Care Transformation Programme has developed best practice tools from a number of workstreams from 2017. This includes service specifications and mobilisation plans alongside support events and tools to aid implementation at a local level.

The programme has established reporting systems with NHS England and NHS Improvement regional teams to provide assurance and support with implementation. The Elective Care Community of Practice enables local systems to share learning about Elective Care Transformation and provides a platform for further engagement and support for local implementation.

It is the responsibility of National Health Service trusts to have staffing arrangements in place that deliver safe and effective care. This includes recruiting the appropriate professionals needed to support these levels and meet local needs.

Dermatology is a highly competitive specialty training pathway and often oversubscribed. Nationally and locally there has been a 100% fill rate in dermatology training for the past four years. Since 2010, the number of full-time equivalent dermatologists (doctors at the consultant grade) has increased by 26% rising from 464 in May 2010 to 584 in May 2019.

The interim NHS People Plan, published on 3 June 2019, puts the workforce at the heart of the NHS and will ensure we have the staff needed to deliver high quality care. In advance of publishing the final People Plan, the NHS will establish a national programme board to address geographical and specialty shortages in medicine.

The National Institute for Health and Care Excellence (NICE) is currently reviewing its technology appraisal and highly specialised technology evaluation methods. The methods review will include a review of a wide range of methods, including those relevant to severe and rare conditions.

The Voluntary Scheme for Branded Medicines Pricing and Access 2019 - an agreement between the Government and the Association of the British Pharmaceutical Industry - states that the standard cost effectiveness threshold used by NICE will be retained at the current range (£20,000 - £30,000 per Quality Adjusted Life Year).

In the current Single Technology Appraisal process there are several factors that may currently be considered by NICE committees when deliberating, including some that may affect the value of a treatment. NICE’s methods review will explore if these factors are still relevant for patients and the National Health Service, whether there is a need to modify the approach and whether any additional factors should be taken into account when making a recommendation on a technology.

The review will also consider other methods that are important for rare and severe conditions, including methods for measuring and valuing the health-related quality of life for people with rare diseases, dealing with uncertainty and sourcing different types of evidence. Proposals will be presented for six weeks of public consultation in the summer of 2020.

Furthermore, in parallel with the methods review, NICE is reviewing its highly specialised technologies topic selection criteria – to make them clearer, more specific, and more transparent and predictable.

It has not proved possible to respond to the hon. Member in the time available before Prorogation.

The United Kingdom is a global leader in providing access to pioneering cell and gene therapies for treating diseases such as cancer, cystic fibrosis, heart disease and diabetes. Indeed, 24% of developers of advanced therapy medicinal products in Europe are headquartered in the UK. Last year the National Health Service was the first health system in Europe to agree full access for a revolutionary new CAR-T treatment, representing one of the fastest funding approvals in the history of our health service.

Together with the Cell and Gene Therapy Catapult we have nine specialist hospitals delivering approved CAR-T therapies as well as three Advanced Therapy Treatment Centres across the UK. These centres have been assigned £30 million by UK Research and Innovation - including project funding and an Apprenticeship Training Scheme.

It has not proved possible to respond to the hon. Member in the time available before Prorogation.

The Department funds research through the National Institute for Health Research (NIHR). The NIHR has a large programme of work to look at the causes of obesity, in addition to research on prevention and treatment. The NIHR has invested £5 million over five years in an Obesity Policy Research Unit which has a programme of work to provide robust evidence and a deeper understanding of the causes of childhood obesity, including research on marketing, food environment and behaviour change.

The NIHR welcomes funding applications for research into any aspect of human health, including obesity; it is not usual practice to ring-fence funds for particular topics or conditions. Applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality.

The importance of good quality food for patients, visitor and staff is recognised both in terms of improving health and for their overall experience of services. Patients have the right to receive tasty, nutritious and free food as part of their National Health Service treatment.

Data is not collected centrally on the number of local senior or executive champions to drive local work on nutrition, the number of commissioners that reviewed existing service provision or agreed improvement trajectories as set out in the guidance.

In July 2018 the Healthcare Food Standards and Strategy Group started a review of the national standards for Healthcare Food for patients, staff and visitors. This work is building on the Hospital Food Panel report of 2014 and is focusing on marking out the way in which organisations need to comply with the five core standards and bringing in a wealth of tools, resources and examples of good practice to help them achieve the standards.

The importance of good quality food for patients, visitor and staff is recognised both in terms of improving health and for their overall experience of services. Patients have the right to receive tasty, nutritious and free food as part of their National Health Service treatment.

Data is not collected centrally on the number of local senior or executive champions to drive local work on nutrition, the number of commissioners that reviewed existing service provision or agreed improvement trajectories as set out in the guidance.

In July 2018 the Healthcare Food Standards and Strategy Group started a review of the national standards for Healthcare Food for patients, staff and visitors. This work is building on the Hospital Food Panel report of 2014 and is focusing on marking out the way in which organisations need to comply with the five core standards and bringing in a wealth of tools, resources and examples of good practice to help them achieve the standards.

The importance of good quality food for patients, visitor and staff is recognised both in terms of improving health and for their overall experience of services. Patients have the right to receive tasty, nutritious and free food as part of their National Health Service treatment.

Data is not collected centrally on the number of local senior or executive champions to drive local work on nutrition, the number of commissioners that reviewed existing service provision or agreed improvement trajectories as set out in the guidance.

In July 2018 the Healthcare Food Standards and Strategy Group started a review of the national standards for Healthcare Food for patients, staff and visitors. This work is building on the Hospital Food Panel report of 2014 and is focusing on marking out the way in which organisations need to comply with the five core standards and bringing in a wealth of tools, resources and examples of good practice to help them achieve the standards.

The importance of good quality food for patients, visitor and staff is recognised both in terms of improving health and for their overall experience of services. Patients have the right to receive tasty, nutritious and free food as part of their National Health Service treatment.

Data is not collected centrally on the number of local senior or executive champions to drive local work on nutrition, the number of commissioners that reviewed existing service provision or agreed improvement trajectories as set out in the guidance.

In July 2018 the Healthcare Food Standards and Strategy Group started a review of the national standards for Healthcare Food for patients, staff and visitors. This work is building on the Hospital Food Panel report of 2014 and is focusing on marking out the way in which organisations need to comply with the five core standards and bringing in a wealth of tools, resources and examples of good practice to help them achieve the standards.

NHS Digital has provided a count of finished admission episodes (FAEs) in each of the last 10 years with a primary or secondary diagnosis of malnutrition for adult and child patients resident in England. This information is provided in the attached tables.

Information by clinical commissioning group and parliamentary constituency is too small to be meaningful and has not been provided in order to protect patient confidentiality.

Activity for adults in English National Health Service Hospitals and English NHS commissioned activity in the independent sector.

Source: Hospital Episode Statistics (HES), NHS Digital

Activity for children in English NHS Hospitals and English NHS commissioned activity in the independent sector.

Source: HES, NHS Digital

Notes:

1. A finished admission episode (FAE) is the first period of admitted patient care under one consultant within one healthcare provider. FAEs are counted against the year or month in which the admission episode finishes. Admissions do not represent the number of patients, as a person may have more than one admission within the period.

2. The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and seven prior to 2002-03) diagnosis fields in the HES data set and provides the main reason why the patient was admitted to hospital.

3. ICD-10 codes used to define malnutrition are:

E40 Kwashiorkor;

E41 Nutritional marasmus E42 Marasmic kwashiorkor;

E43 Unspecified severe protein–energy malnutrition;

E44 Protein–energy malnutrition of moderate and mild degree;

E45 Retarded development following protein–energy malnutrition;

E46 Unspecified protein–energy malnutrition; and O25 Malnutrition in pregnancy.

5. Adult: the patient was 18 years old or greater at the start of the episode of care.

6. Child: the patient was under 18 years old at the start of the episode of care.

NHS Digital has provided a count of finished admission episodes (FAEs) in each of the last 10 years with a primary or secondary diagnosis of malnutrition for adult and child patients resident in England. This information is provided in the attached tables.

Information by clinical commissioning group and parliamentary constituency is too small to be meaningful and has not been provided in order to protect patient confidentiality.

Activity for adults in English National Health Service Hospitals and English NHS commissioned activity in the independent sector.

Source: Hospital Episode Statistics (HES), NHS Digital

Activity for children in English NHS Hospitals and English NHS commissioned activity in the independent sector.

Source: HES, NHS Digital

Notes:

1. A finished admission episode (FAE) is the first period of admitted patient care under one consultant within one healthcare provider. FAEs are counted against the year or month in which the admission episode finishes. Admissions do not represent the number of patients, as a person may have more than one admission within the period.

2. The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and seven prior to 2002-03) diagnosis fields in the HES data set and provides the main reason why the patient was admitted to hospital.

3. ICD-10 codes used to define malnutrition are:

E40 Kwashiorkor;

E41 Nutritional marasmus E42 Marasmic kwashiorkor;

E43 Unspecified severe protein–energy malnutrition;

E44 Protein–energy malnutrition of moderate and mild degree;

E45 Retarded development following protein–energy malnutrition;

E46 Unspecified protein–energy malnutrition; and O25 Malnutrition in pregnancy.

5. Adult: the patient was 18 years old or greater at the start of the episode of care.

6. Child: the patient was under 18 years old at the start of the episode of care.

Information could only be obtained at disproportionate cost.

Our focus is on tackling the causes of obesity, improving diets and preventing ill health. Many of the measures in the chapters of the childhood obesity plan will have an impact on tackling obesity and improving diets across all age groups.

In addition, Public Health England encourages the population to follow a healthy balanced diet through the 5 A Day campaign, Change4Life and OneYou social marketing campaigns.

As part of the NHS Long Term Plan, the National Health Service has committed to sequencing 500,000 whole genomes by 2023/24.

During 2019, whole genome sequencing will be available as part of routine NHS clinical care for some patients with rare disease and cancer, where there is evidence that it is clinically effective. The conditions are outlined in the National Genomic Test Directory which specifies which genomic tests are commissioned by the NHS in England, the technology by which they are available, and the patients who will be eligible to access to a test. This is available at the following link:

https://www.england.nhs.uk/publication/national-genomic-test-directories/

Genomics England has consulted charities, patient groups and participants from the 100,000 Genomes Project during the development of consent materials for the use of data from whole genome sequencing in research. Genomics England has also engaged with and sought input from charities and participants as it explores how best to realise the ambition to sequence five million genomes.

The NHS Genomic Medicine Centres established by NHS England to support the delivery of the 100,000 Genomes project have engaged with patients, the public and the independent sector. In addition, as part of the development of the NHS Genomic Medicine Service, NHS England is working with charities and patient organisation to help develop patient facing materials and information that will be used to support the introduction of whole genome sequencing in the National Health Service.

The Government is committed to making the United Kingdom home of genomic healthcare and the National Genomic Healthcare Strategy, which we plan to launch in autumn 2019, will set out how the genomics community can work together to make the UK the global leader. The Government is consulting widely - including with charities and patient organisations - in the development of the National Genomics Healthcare Strategy.

The National Health Service published its interim People Plan on 3 June. It sets out a plan of action to meet the long-term challenges of supply, reform, culture and leadership, and puts NHS people at the heart of NHS policy and delivery.

In developing this plan, the NHS has engaged widely with staff, patients, employers, professional organisations, regulatory bodies, voluntary sector, academia and other experts.

In advance of publishing the final People Plan, the NHS will establish a national programme board to address geographical and specialty shortages in medicine. We expect the final People Plan to be published soon after the Spending Review.

The commissioning and configuration of dermatology services in England is a local matter. The local National Health Service is best placed to make decisions that ensure services meet the needs of resident populations in the most appropriate way.

Clinical commissioning groups (CCGs) are responsible for commissioning the vast majority of dermatology services. The majority of patients with dermatological disorders are managed in primary and community care. Wolverhampton CCG is currently re-procuring its community dermatology service which will encompass an extended range of services. This procurement has been undertaken with the knowledge and co-operation of Royal Wolverhampton Trust. The Royal Wolverhampton Trust is also exploring with other trusts how to make the best use of scarce dermatology staff by working with each other more closely.

Health Education England (HEE) published the Cancer Workforce Plan for England in December 2017, which committed to the expansion of capacity and skills of the cancer workforce, including an ambition to attract and retain more cancer specialists, including histopathologists, by 2021. In 2019, 100% of specialist pathology training places, including histopathology, were filled.

Following the publication of the NHS Long Term Plan in January 2019, HEE is now working with NHS England and NHS Improvement to understand the longer-term workforce implications for the further development of cancer services.

Locally, responsibility for assessing and managing staffing levels, including specialty staff, rests with individual NHS trusts who are best placed to decide how many staff they need to provide a given service.

The requested information is not held centrally. No assessment has been made of the effect on patients of clinical commissioning groups (CCGs) decommissioning tier 3 and tier 4 weight management services. CCGs have a statutory responsibility to commission services which meet the healthcare needs of their local population.

The requested information is not held centrally. No assessment has been made of the effect on patients of clinical commissioning groups (CCGs) decommissioning tier 3 and tier 4 weight management services. CCGs have a statutory responsibility to commission services which meet the healthcare needs of their local population.

The requested data is not centrally collected.

NHS Digital has advised that obesity data for children and adults in England by age and gender for each of the last five years is available in the Health Survey for England. This information is attached. Data is not available by clinical commissioning group.

We want all health care professionals to feel confident utilising their skills and everyday opportunities to talk about weight and provide advice to support healthier weight. In Chapter 2 of the Childhood Obesity Plan, we outlined our commitment to provide health and care professionals with the latest training and tools to better support children, young people and families to reduce obesity.

It is the responsibility of Higher Education Institutes to set the curricula for the pre-registration training of healthcare professionals to standards set by the individual regulators of each profession.

There are no current plans to develop a national obesity strategy for adults and children. Many of the key measures in both chapters of our childhood obesity plan will have an impact on tackling obesity across all age groups. These include the soft drinks industry levy, sugar reduction and wider calorie reformulation programme, restricting promotions and calorie labelling in restaurants which will improve our eating habits and reduce the amount of sugar we consume.

The information is shown in the attached table.

The Department has not assessed the cost effectiveness of increasing the number of donations from black, Asian and minority ethnic people of blood, stem cells and organs.

Information on the potential savings of reducing the number of people on dialysis is not available in the format requested.

An impact assessment prepared to support the consultation on proposed changes to consent for organ and tissue donation, which ran between December 2017 and March 2018, includes cost and benefit analysis information in respect of all organs, including kidney transplants. The impact assessment was limited to the cost/benefit analysis of changes to consent arrangements in England, and is available at the following link:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/666518/Organ_Donation_Opt-Out_Consultation_Impact_Assessment.pdf

This data is not available in the format requested. The following table shows the total activity, total cost and national average unit cost for all types of renal dialysis.

The activity count for renal dialysis is the number of sessions, not the number of patients. All data shown is for financial year 2016-17, the most recent year for which reference costs have been collected. National Health Service references costs data can be found at the following link:

https://improvement.nhs.uk/resources/reference-costs/

The individual Healthcare Resource Groups (HRGs) which make up these data can be found in the following table.

2016-17 HRGs for renal dialysis